Japan Digestive Disease Week 2025
International Poster Session1 (JDDW)
October 31, 9:30–10:18, Room 15 (Kobe International Exhibition Hall No.1 Building Digital Poster Venue)
IP-4_E
Prognostic Factors for Clinical Failure Following Self-Expandable Metal Stent Placement in Malignant Esophageal Stricture
- 1
- Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital
Background
Self-expandable metal stents (SEMS) play a key role in palliative treatment for malignant esophageal strictures. However, some patients still experience persistent dysphagia despite successful stent placement. This study aims to identify the prognostic factors that affect clinical outcomes after SEMS insertion in these patients.
Methods
Between November 2009 and January 2024, 220 patients who underwent successful endoscopic SEMS placement for malignant esophageal stricture in an academic referral center were included in the analysis. We retrospectively evaluated variables associated with clinical outcomes following successful SEMS placement using univariate and multivariate analyses.
Results
The clinical success rate of endoscopic SEMS placement was 77.7%. The average age of patients was 78 years, with a male predominance (82.7%). The main causes of malignant strictures were squamous cell carcinoma (59.5%) and gastric cancer (25.9%). Endoscopic passage failed in 31.4% of cases. At baseline, 42.3% had poor performance status (ECOG 2-3), 67.3% had severe dysphagia, and 11.8% had carcinomatosis peritonei. Narcotics were needed for pain management in 37.7% of patients. Multivariate analysis identified the need for narcotics, presence of carcinomatosis peritonei, and poor performance status (ECOG 2-3) as significant predictors of clinical failure after stent placement.
Conclusion
The need for narcotics after SEMS placement, presence of carcinomatosis peritonei, and poor performance status (ECOG 2-3) are significantly associated with clinical failure of palliative SEMS placement.
Self-expandable metal stents (SEMS) play a key role in palliative treatment for malignant esophageal strictures. However, some patients still experience persistent dysphagia despite successful stent placement. This study aims to identify the prognostic factors that affect clinical outcomes after SEMS insertion in these patients.
Methods
Between November 2009 and January 2024, 220 patients who underwent successful endoscopic SEMS placement for malignant esophageal stricture in an academic referral center were included in the analysis. We retrospectively evaluated variables associated with clinical outcomes following successful SEMS placement using univariate and multivariate analyses.
Results
The clinical success rate of endoscopic SEMS placement was 77.7%. The average age of patients was 78 years, with a male predominance (82.7%). The main causes of malignant strictures were squamous cell carcinoma (59.5%) and gastric cancer (25.9%). Endoscopic passage failed in 31.4% of cases. At baseline, 42.3% had poor performance status (ECOG 2-3), 67.3% had severe dysphagia, and 11.8% had carcinomatosis peritonei. Narcotics were needed for pain management in 37.7% of patients. Multivariate analysis identified the need for narcotics, presence of carcinomatosis peritonei, and poor performance status (ECOG 2-3) as significant predictors of clinical failure after stent placement.
Conclusion
The need for narcotics after SEMS placement, presence of carcinomatosis peritonei, and poor performance status (ECOG 2-3) are significantly associated with clinical failure of palliative SEMS placement.
- Index Term 1: Malignancy
- Index Term 2: Stent